Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study

BMC Geriatrics

Johanna Nordheim¹  Paul Gellert¹  Julie L. O’Sullivan¹  Sonia Lech²  Wolfram Herrmann³  Johanna Drewelies⁴  Robert P. Spang⁵  Jan-Niklas Voigt-Antons⁶ 

[1] Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany;Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117, Berlin, Germany;Brandenburg Medical School Theodor Fontane, Department of Psychiatry, Psychotherapy and Psychosomatics, Neuruppin, Germany;Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of General Practice, Berlin, Germany;Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany;Technische Universität Berlin, Quality and Usability Lab, Berlin, Germany;Technische Universität Berlin, Quality and Usability Lab, Berlin, Germany;Deutsches Forschungszentrum für Künstliche Intelligenz GmbH (DFKI), Speech and Language Technology, Berlin, Germany;

关键词: Dementia;    Primary care;    Adherence to dementia guideline;   

DOI  :  10.1186/s12877-021-02650-8

来源: Springer

【 摘 要 】

BackgroundGeneral practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices.MethodsA cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life.ResultsSelf-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25–100). Adherence to specific recommendations varied widely (from 19.2 to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = − 5.58, CI = − 10.97, − 0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = −.86, CI = − 4.18, 2.47, p = .61).ConclusionThe present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care.Trial registrationThe DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019.

【 授权许可】

CC BY